Hampshire and Isle of Wight Healthcare NHS Foundation Trust

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

We rated this key question as good because:

• Staff assessed the physical health of all patients on admission.
• They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed.
• Staff provided a range of treatment and care for patients based on national guidance and best practice.
• The ward team included or had access to the full range of specialists required to meet the needs of patients on the ward.
• Staff from different disciplines worked together as a team to benefit patients.
• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We looked at patient care and treatment records on each of the 11 wards.

Staff completed a comprehensive mental health assessment of the patient in a timely manner at, or soon after, admission.

Staff assessed patients’ physical health needs in a timely manner after admission. During the last inspection under the previous provider at Elmleigh ward, in 2023 we identified concerns about how patients’ physical health was monitored. At this inspection we identified that improvements had been made and there was no concern in relation to how patients’ physical health was monitored.

Staff developed care plans that met the needs identified during assessment.

Care plans were not always personalised, holistic and recovery-oriented. The quality of care plans varied between wards with some detail being generic and not specific to the patient. This was an issue identified at Parklands and Antelope House.

Quality Statement Score 3

3. We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were delivered in line with guidance from the National Institute for Health and Care Excellence. These included medicines and psychological therapies.

Staff ensured patients had good access to physical healthcare, including access to specialists when needed. Specialist health professionals were involved in peoples care as needed. For example, speech and language therapists (SALT) and tissue viability nurses (TVN).

The quality and quantity of food provided to people varied across the wards and several patients commented on how they didn’t enjoy the food and often chose to order takeaways. The food was rated poorly by patients at Parklands, Antelope House and Elmleigh. Leaders acknowledged some patients' dissatisfaction with the food provided and it was regularly discussed at community meetings.

Staff participated in clinical audit, benchmarking and quality improvement initiatives.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group.

Mental Health Act

Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.

Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.

Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.

Patients had easy access to information about Independent Mental Health Advocacy (IMHA). IMHA posters were on the wards and we spoke with 3 IMHAs who were on the wards during our inspection. Staff explained to patients their rights under the Mental Health Act 1983 in a way that they could understand, repeated it as required and recorded that they had done it. We reviewed Section 132 rights forms which had been completed. This demonstrated that patients had been reminded of, and understood, their rights whilst detained under the Mental Health Act 1983.

Staff ensured that detained patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted.

Staff requested a second opinion appointed doctor when necessary.

Staff stored copies of patients' detention papers and associated records, for example, Section 17 leave forms, correctly and so that they were available to all staff that needed access to them.

The service displayed a notice to tell informal patients that they could leave the ward freely. We saw these signs on the entrance and exit doors in all the wards we visited.

Care plans referred to identified Section 117 aftercare services to be provided for those who had been subject to Section 3. There was evidence of discharge planning involving Section 117 aftercare arrangements.

Staff did regular audits to ensure that the Mental Health Act was being applied correctly and there was evidence of learning from those audits.

They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services

Staff shared information about patients at effective handover and multidisciplinary meetings with other staff. We attended some multidisciplinary and handover meetings during our inspection and saw evidence of relevant information being shared appropriately.

The teams had effective working relationships, including good handovers, with other relevant teams within the organisation including community teams.

The teams had effective working relationships with teams outside the organisation.

There was evidence of multi-agency working including with local social care providers.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control.

The service supported people to live healthier lives and, where possible, reduce their future need for care and support.

Staff supported patients to live healthier lives. For example, through participation in smoking cessation schemes, healthy eating advice, managing cardiovascular risks and dealing with issues relating to substance misuse.

Ward activities helped promote a healthy lifestyle for patients. For example, walking groups, sports activities and cooking healthy meals. We saw some of the Occupational Therapists (OT) and activity coordinators running healthy lifestyle activities. Some wards held regular escorted walking groups.

Description: We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

Quality Statement Score:3

3. We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people who use services

Staff used recognised rating scales to assess and record severity and outcomes. For example, health of nation outcome scale (HONOS).

Staff used technology to support patients effectively. For example, MHA spreadsheets with all reviews and dates recorded clearly. That ensure all patients MHA information was regularly updated and easily accessible for all staff.

Description: We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

Quality Statement Score:3

3. We scored the service as 3. The evidence showed a good standard.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable patients to make their own decisions

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately.

They did this on a decision-specific basis with regard to significant decisions.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.

We saw evidence of Mental Capacity Act assessments completed by staff. For example regarding specific decisions about taking medication